Pseudoaneurisma de artéria renal após trauma renal fechado
relato de três casos e revisão da literatura
Palavras-chave:
Hematuria, Artéria renal, Ferimentos não penetrantes, Aneurisma, Embolização terapêuticaResumo
CONTEXTO: Pseudoaneurisma de artéria renal é uma complicação rara após lesão renal, mas deve ser suspeitada quando houver hematúria recorrente após trauma renal. RELATO DE CASOS: Três casos de pseudoaneurisma após trauma renal fechado são apresentados, além de revisão da literatura. Todos os pacientes foram submetidos a angiografia renal. Dois dos casos foram diagnosticados durante a estadia hospitalar inicial, por hematúria ou no período de acompanhamento durante a recuperação. Um paciente estava hemodinamicamente instável. Dois pacientes foram submetidos a embolização com coil com sucesso em uma única sessão. No outro caso, a embolização seletiva foi tentada sem sucesso, devido à impossibilidade de cateterização da artéria. O sucesso médico e do procedimento e as complicações foram retrospectivamente avaliados a partir dos registros dos pacientes. A apresentação clínica, opções de tratamento e decisões clínicas são discutidas. CONCLUSÕES: Pseudoaneurisma de artéria renal pode se desenvolver agudamente ou até mesmo anos após o trauma inicial. Sinais e sintomas podem ter um amplo espectro de apresentação. Embolização angiográfica seletiva é um tratamento efetivo, reduzindo a extensão de infarto parenquimatoso.
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